5280 Pediatric Dentistry
Dentist, Pediatric Dentistry in Lone Tree, CO. Organization (NPI-2).
NPI number1467828905
StatusActive
Last updated in NPPESAug 19, 2015
Details
- NPI
- 1467828905
- Entity type
- Organization (NPI-2)
- Legal business name
- 5280 Pediatric Dentistry
- Organization subpart
- No
- Enumeration date
- Aug 19, 2015
- Last updated
- Aug 19, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 0020124 | CO | Yes |
Practice location
10463 Park Meadows DrSuite 206
Lone Tree, CO 80124-5316
Phone 303-601-5280
Mailing address
10463 Park Meadows DrSuite 206
Lone Tree, CO 80124-5316
Phone 303-601-5280
Authorized official
Derek Stephen Owens
Owner
3033496480
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